COST-EFFECTIVENESS OF A STRUCTURED TREATMENT AND TEACHING PROGRAM ON ASTHMA

The purpose of this study was to perform a cost-effectiveness analysis of the structured treatment and teaching programme for patients with asthma (ATTP) at Dusseldorf University. We investigated whether the mo netary benefits outweighed the costs of the intervention. Adult patien ts with moderate to severe asthma participated in a 5 day in-patient p rogramme. Follow-up was 3 yrs. The incremental costs and benefits of t he intervention, compared with standard treatment, were calculated. Co sts were incurred by the hospitalization and by lost productivity. Com pared to the year before the programme, (average reduction) days spent in hospital (5.2 days per patient per year), days of absence from wor k (18.4 days per patient per year), acute severe asthma attacks (3.8 a ttacks per patient per year), and physician consultations (2.3 visits per patient per month), decreased in the 3 yrs after the intervention. The programme produced net benefits of DM 12,850 (in 1991 German mark s) per patient within 3 yrs. Within the health care sector, the net be nefits were DM 5,900. Within 3 yrs, the paying bodies saved DM 2.70, a nd society as a whole saved DM 5 on each DM spent for the programme. W e conclude that the intervention produced net monetary benefits. This result was stable over a wide range of variation of the outcome measur es. Therefore, the programme deserves implementation, not only for its demonstrated medical benefits but also for its economic savings.